DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20221753
Published: 2022-06-28

A retrospective study to analyse epidemiological profile of community acquired infectious keratitis in a tertiary care hospital located in Northern Mumbai

Kinjal Prashant Patel, Sapna Kini, Manjula Ballamudi, Reshma Ashwin Poojary

Abstract


Background: Epidemiology of infectious keratitis varies with geographical location. The aim of the study was to review the etiology of infectious keratitis in community that will help in management strategy.

Methods: A retrospective study was conducted at tertiary care hospital from November 2017 to December 2020. Corneal scrapings and corneal button were processed as per microbiological standards. Bacterial identification and antimicrobial sensitivity testing was done by automated Vitek-2 compact system. Significant fungal growth was confirmed by its colony morphology, pigment production and lacto phenol cotton blue (LPCB) mount examination.

Results: Of total 130 patients, culture positivity was 63 (48%), of these 59 (53%) were from corneal scrapping and 4 (21%) from corneal button. The most common bacterial isolates were Streptococcus pneumoniae 12 (38%), followed by Pseudomonas aeruginosa 6 (19%) and Staphylococcus aureus 4 (12%). The most common fungi isolated was Fusarium spp 14 (47%) followed by Aspergillus spp 9 (30%). One specimen showed Acanthamoba spp in wet mount preparation. Major associated factors were injury with vegetative matter 30 (48%) followed by contact lens use 12 (19%) and diabetes mellitus 11 (17%). Antibiotic susceptibility tests showed that all gram-positive cocci were susceptible to vancomycin (100%) and fluoroquinolones (100%) followed by third generation cephalosporins (80%). Whereas all gram-negative bacilli were susceptible to aminoglycosides (100%) followed by fluoroquinolones (90%).  

Conclusions: Epidemiology of infectious keratitis vary with geographical location. Understanding local microbiological profile assist in empirical therapy when diagnostic facilities are not readily available.


Keywords


Antimicrobial susceptibility pattern, Bacterial, Corneal scrapping, Fungal, Keratitis, Parasitic

Full Text:

PDF

References


Bourne RRA, Flaxman SR, Braithwaite T, Cicinelli MV, Das A, Jonas JB, et al. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health. 2017;5(9):888-97.

Khor WB, Prajna VN, Garg P, Mehta JS, Xie L, Liu Z, et al. The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study of Infectious Keratitis in Asia. Am J Ophthalmol. 2018;195:161-70.

Das S, Konar J. Bacteriological profile of corneal ulcer with references to Antibiotic susceptibility in a tertiary care hospital in West Bengal. IOSR J Dent Med Sci. 2013;11:72-5.

Reddy M, Sharma S, Rao GN. In: Dutta LC, eds. Corneal ulcer. Modern Ophthalmology. 2nd ed. New Delhi: Jaypee brothers: 2000; 1: 200-16.

Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012;96(5):614-8.

Gopinathan U, Garg P, Fernandes M, Sharma S, Athmanathan S, Rao GN. The epidemiological features and laboratory results of fungal keratitis: a 10-year review at a referral eye care center in South India. Cornea. 2002 Aug;21(6):555-9.

Asbell PA, Sanfilippo CM, Pillar CM, DeCory HH, Sahm DF, Morris TW. Antibiotic Resistance Among Ocular Pathogens in the United States: Five-Year Results From the Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) Surveillance Study. JAMA Ophthalmol. 2015;133(12):1445-54.

Ni N, Nam EM, Hammersmith KM, Nagra PK, Azari AA, Leiby BE, et al. Seasonal, geographic, and antimicrobial resistance patterns in microbial keratitis: 4-year experience in eastern Pennsylvania. Cornea. 2015;34(3):296-302.

Srinivasan M, Gonzales CA, George C, Cevallos V, Mascarenhas JM, Asokan B, et al. Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India. Br J Ophthalmol. 1997;81(11):965-71.

Sharma S, Athmanathan S. Diagnostic procedure in infectious Keratitis. In: Nema HV, Nema N, eds. Diagnostic procedure in ophthalmology. New Delhi: Jaypee brothers; 2002: 232-53.

Tille PM. Bailey and Scott's Diagnostic Microbiology. St. Louis, Missouri: Elsevier; 2014.

CLSI. CLSI guidelines Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: 18th Informational Supplement. CLSI Document M100-S18. Wayne, PA: CLSI; 2019.

Assudani HJ, Pandya JM, Sarvan R, Sapre AM, Gupta AR, Mehta SJ. Etiological diagnosis of microbial keratitis in a tertiary care hospital in Gujarat. Natl J Med Res. 2013;3:60.

Yousuf N. Microbial keratitis in kingdom of bahrain: clinical and microbiology study. Middle East Afr J Ophthalmol. 2009;16(1):3-7.

Bakshi R, Rajagopal R, Sitalakshmi G, Sudhi R, Madhavan H, Bagayalakshmi R. Clinical and Microbiological Profile of Fungal Keratitis: A 7 Year Study at a Tertiary Hospital in South India. Cornea Session III; AIOC 2008 Proceedings; 2008: 207-209.

Saha R, Das S. Mycological profile of infectious Keratitis from Delhi. Indian J Med Res. 2006;123(2):159-64.

Cao J, Yang Y, Yang W, Wu R, Xiao X, Yuan J, et al. Prevalence of infectious keratitis in Central China. BMC Ophthalmol. 2014;14:43.

Ranjini CY, Waddepally VV. Microbial Profile of Corneal Ulcers in a Tertiary Care Hospital in South India. J Ophthalmic Vis Res. 2016;11(4):363-7.

Krishna S, Shafiyabi S, Sebastian L, Ramesha R, Pavitra D. Microbial keratitis in Bellary district, Karnataka, India: Influence of geographic, climatic, agricultural and occupational risk factors. Int J Pharm Biomed Res. 2013;4:189-93.

Schaefer F, Bruttin O, Zografos L, Crosier Y. Bacterial keratitis: a prospective clinical and microbiological study. Br J Ophthalmol. 2001;85(7):842-7.

Leck AK, Thomas PA, Hagan M, Kaliamurthy J, Ackuaku E, John M, et al. Aetiology of suppurative corneal ulcers in Ghana and south India, and epidemiology of fungal keratitis. Br J Ophthalmol. 2002;86(11):1211-5.

Bharathi MJ, Ramakrishnan R, Meenakshi R, Padmavathy S, Shivakumar C, Srinivasan M. Microbial keratitis in South India: influence of risk factors, climate, and geographical variation. Ophthalmic Epidemiol. 2007;14(2):61-9.

Narsari AK, Quraishy MM, Lohana MK, Jatoi SM, Khanzada MA. Demographic pattern, Risk factors, clinical and microbiological characteristics of microbial keratitis at a tertiary care hospital. Med Channel. 2009;15(4):89-94.

Passos RM, Cariello AJ, Yu MC, Höfling-Lima AL. Microbial keratitis in the elderly: a 32-year review. Arq Bras Oftalmol. 2010;73(4):315-9.

Somabhai KR, Dhanjibhai PN, Sinha M. A clinical microbiological study of corneal ulcer patients at western Gujarat, India. Acta Med Iran. 2013;51(6):399-403.

Alkatan H, Athmanathan S, Canites CC. Incidence and microbiological profile of mycotic keratitis in a tertiary care eye hospital: A retrospective analysis. Saudi J Ophthalmol. 2012;26(2):217-21.

Idiculla T, Zachariah G, Keshav B, Basu S. A retrospective study of fungal corneal ulcers in the South sharqiyah region in oman. Sultan Qaboos Univ Med J. 2009;9(1):59-62.

Narsani AK, Jatoi SM, Lohana MK, Dabir SA, Gul S, Khanzada MA. Hospital based epidemiology, risk factors and microbiological diagnosis of bacterial corneal ulcer. Int J Ophthalmol. 2009;2:362-6.

Forbes BA, Sahm DF, Weissfeld AS. Infections of the eyes, ears and sinuses. In: Forbes BA, Sahm DF, Weissfeld AS, eds. Bailey and Scott’s Diagnostic Microbiology. 12th ed. St. Louis: Mosby; 2007: 832-837.